Introduction/Background Endometrial cancer is the most common pelvic gynecological cancer in European countries and its frequency increases with age. Given the gradual increase in life expectancy in European countries, it is expected that this malignancy will be diagnosed more frequently in women of advanced ages. The goal of this study was to evaluate the demographic characteristics, pathology, treatment, prognostic factors and survival rates in elderly patients with EC and to compare their results with those of younger ones, in order to define the specific characteristics of this malignancy in this population.
Methodology Analysis of all EC patients managed at the University Hospital of the Canary Islands between 1990–2016. Survival curves were calculated by using the Kaplan-Meier method and compared with the log-rank test. Logistic regression analysis was used to assess the independent effect of different variables on CSS. Statistical significance was considered for p<0.05.
Results The study included 1799 EC patients; 170 of them (9.4%) were 80 years old or older. Elderly patients received less surgery (68.2% vs. 92.4%), lymphadenectomy (10.3% vs. 26.2%) and adjuvant treatment (37.1% vs. 51.2%) than younger ones, and presented higher probability of receiving palliative treatment (27.6% vs. 4%). Endometrioid tumors were more frequently diagnosed in younger patients (78.8% vs. 62.9%), while type 2-EC was more frequently diagnosed in elderly ones (37.1% vs. 21.2%).
CSS in older patients was significantly poorer than in younger ones, with a mean of 61.4 months (95%CI 51.7–71.1) versus 226 months (95%CI 218.9–233.1), respectively. In a multivariate analysis: age, FIGO stage, histology, tumor differentiation and adjuvant treatment were independently associated with survival.
Conclusion Although EC is more aggressive in older patients, they are less likely to receive optimal treatment, which negatively affects their survival. Specific guidelines for the management of this population, including a comprehensive geriatric assessment, should be developed to improve their prognosis.
Disclosure Nothing to disclose.
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